VendorRegistration

2019 Vendor Registration Form

First Name

Last Name

Address

City

State

Zip

Phone

All instructions are contained within these registration documents.

Vender team(s) must consist of at least one adult persons.

Cost for vendor space is $20.00

Product:

Name of Product

Click on Submit below or print and Mail this registration form to: The Wisconsin Black Chamber of Commerce, Inc. 3020 W Vliet Street, Milwaukee, WI 53208 (414-306-6460).

Please send me additional membership information for:

Waiver & Release from Liability: I hereby absolve myself, my heirs, executor and administrators of any and all rights and claims of damages I may accrue against The Wisconsin Black Chamber of Commerce, Inc., and Mcgovern Park, the Milwaukee Fatherhood Collaborative, the City of Milwaukee, its officials; or any and all private homeowners; or any and all people in facilities connected with the Men Who Cook / Dads Who Cook event for any and all injuries suffered by me while participating in the Men Who Cook Event. (Note if entrant is under eighteen (18) years of age, a parent must sign the waiver, too.)

Full Name:

Signature

Date

Deadline for Vendor Registration: August 15, 2019